International AIDS Conference Opens In D.C.

The 19th International AIDS Conference is underway in Washington. More than 20,000 people are in this city from around the world to discuss the latest developments in the effort to prevent the spread of HIV and help people who already have it. NPR health and science correspondent Richard Knox is here to talk about the meeting. Richard, good morning.

RICHARD KNOX, BYLINE: Good morning.

INSKEEP: Natural that you'd have a big meeting like this in Washington, global capital, but there's also a story about AIDS in Washington, D.C.

KNOX: That's right. I think the conference organizers were very explicit in saying to us that they picked Washington because it has the nation's worst AIDS problem. Something like 3 percent of people in D.C. have HIV. And to put that in some context, that's about the same as Nigeria, as Rwanda, as Burundi in Africa. It's really a pretty significant problem.

INSKEEP: I want to underline that for a moment, because have heard for years about how there is an unbelievably devastating AIDS problem in Africa, and you're naming a bunch of African nations and saying Washington, D.C., this nation's capital, is in about the same league.

KNOX: Well, it's not as bad as many countries in Africa. They have as high as 25 percent of adults infected. But it's, you know, it's certainly much worse than I think many people appreciate, and certainly the worst in this country.

INSKEEP: Okay. So that's what's happening in Washington, D.C. If we go out across the country, around the world, what's happening with AIDS right now?

KNOX: Thirty-four million people around the globe are living with HIV. That number has been going up, because more people are getting treated than ever before.

INSKEEP: Meaning that people are able to live longer, the numbers increase. In some ways, that's a good story, but in many ways, a very, very grim story.

KNOX: Well, there's still lots of people, millions getting infected every year, as millions more are living longer. About 60 percent of people in sub-Saharan Africa are getting treatment who need it now, and that's pretty remarkable. It varies a lot, though, around the world. In Eastern Europe, where the epidemic is largely driven by needle drug use, only something like one in four people are getting treatment now. So, you know, it's a mixed picture, but there's definite progress.

INSKEEP: You and your colleagues at the NPR science desk have brought us some really remarkable reporting about changes in the way that people think about AIDS, changes in the way that people treat HIV, more and more aggressive efforts to get more people drugs and the possible changes there. That leads to the next question: What's next? What is it that the thousands of people at this conference envision that could take the attack on AIDS to the next level?

KNOX: I think topic A at this conference is going to be what some people call test and treat. It means being much more aggressive about going out there and testing people, finding the people who carry the virus who don't know it. So there's a great effort to go out and find them, and then get them under treatment as soon as possible. That is known to be good for the individual, because they're going to do better. They're going to stay healthier in the long run. And it's also good for the community, because if you're in treatment, you can reduce the level of the virus to nearly zero in your blood, and therefore, you're not spreading it to other people.

This is a big change from the previous policy, which you might call test and wait. Basically, you would test people. If they were positive, you would monitor them and you would wait until their immune system got to a certain point before you'd start treating.

INSKEEP: Of course, if you're going to treat more people more quickly, at least in the short term, it's going to cost more money. Is there appetite to pay for that in this time of budget problems and debt problems in so many countries?

KNOX: Well, that's certainly the elephant in the room - or maybe the elephant in the convention center - and it always has been for AIDS. But things have been actually pretty good in the funding realm over the past years. But in the past couple of years, international donor support has flat-lined. Another interesting thing I think we just learned recently, that the total number of countries that are actually attacking their own AIDS problem their own funds is actually bigger now than the international donors. That means that they're showing more political will to putting their own resources in, but it's not going to be enough.